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BrainWaves #137 Neurologists as medical actuaries

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 25, 2019

For patients who survive cardiopulmonary arrest but do not wake up, neurologists are called to the bedside to prognosticate. And the question of “How much will this patient recover?” is not unlike “What is the benefit of aggressive therapy to await possible recovery?” In that way, you might consider neurologists to be the actuaries of hospital medicine. In this week's program, we review the clinical and diagnostic data that neurologists incorporate into their model for outcome prediction following anoxic brain injury.

Produced by James E Siegler. Music courtesy of Swelling, Soft and Furious, Rafael Archangel, Lovira, and Dark Room. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.


Booth CM, Boone RH, Tomlinson G, Detsky AS. Is this patient dead, vegetative, or severely neurologically impaired? Assessing outcome for comatose survivors of cardiac arrest. JAMA 2004;291(7):870-9. PMID 390099 PMID: 14970067

Callaway CW, Donnino MW, Fink EL, et al. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132(18 Suppl 2):S465-82. Erratum in: Circulation 2017;136(10 ):e197. PMID 390099 PMID: 26472996

Jorgensen EO, Holm S. The natural course of neurological recovery following cardiopulmonary resuscitation. Resuscitation 1998;36(2):111-22. PMID 9571727

Nielsen N, Wetterslev J, Cronberg T, et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med 2013;369(23):2197-206. PMID 24237006

Sandroni C, D'Arrigo S. Neurologic prognostication: neurologic examination and current guidelines. Semin Neurol 2017;37(1):40-7. PMID 28147417

Sandroni C, Cariou A, Cavallaro F, et al. Prognostication in comatose survivors of cardiac arrest: an advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine. Resuscitation 2014;85(12):1779-89. PMID 25438253

Seder DB. Management of comatose survivors of cardiac arrest. Continuum (Minneap Minn) 2018;24(6):1732-52. PMID 30516603

Seder DB, Sunde K, Rubertsson S, et al. Neurologic outcomes and postresuscitation care of patients with myoclonus following cardiac arrest. Crit Care Med 2015;43(5):965-72. PMID 25654176

Young GB. Clinical practice. Neurologic prognosis after cardiac arrest. N Engl J Med 2009;361(6):605-11. PMID 19657124

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

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